TREATMENT TACTICS FOR GENITAL PROLAPSES IN WOMEN WITH ABNORMAL UTERINE BLEEDING AND THYROID GLAND PATHOLOGY

Abstract

Introduction. Patients with genital prolapse have various extragenital pathologies, in particular thyroid pathology, which affects the regulation of the menstrual cycle both in the reproductive and perimenopausal periods of a woman's life. Abnormal uterine bleeding caused by hormonal disorders, functional and organic changes in the thyroid gland is reported as a common problem of perimenopausal age. The aim of this study is to optimize the treatment of genital prolapse in women with abnormal uterine bleeding and thyroid pathology. Materials and methods. 49 perimenopausal women with genital prolapse who had thyroid pathology were examined and treated. They were divided into the main group (29 women with abnormal uterine bleeding) and the comparison group of 20 patients with genital prolapse without abnormal uterine bleeding. 20 women without signs of gynaecological and extragenital pathology made up the control group. Results. The presence of significant deviations in the serum content of steroid hormones in women with thyroid dysfunction allows us to confirm the relationship between proliferative processes in the endometrium and the functioning of the thyroid system. The examination revealed a significant relationship between thyroid dysfunction and the cause of abnormal uterine bleeding. Depending on the treatment method, the women of the main group were divided into 2 subgroups: the first subgroup included 19 patients who underwent vaginal extirpation of the uterus and simultaneous correction of genital prolapse with additional sacrospinal fixation of the vaginal stump using a mesh implant fragment. 10 patients were included in the second subgroup, which underwent hysteroresectoscopy due to abnormal uterine bleeding, and surgical treatment of genital prolapse was performed after a certain period of time (after 0.5-3 years, on average after 21-24 months). In the comparison group, planned vaginal extirpation of the uterus was performed. Conclusion. The improvement of the treatment of genital prolapse in women with abnormal uterine bleeding and thyroid pathology consists in combining vaginal removal of the uterus followed by strengthening of the vaginal dome through the use of sacrospinal fixation and/or a mesh implant in order to prevent recurrences and improve the economic indicators of the medical institution and the quality of life of patients.